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Currents Spring 2011

Currents Spring 2011

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This new asthma and allergy publication is produced by the Canadian Network for Respiratory Care in conjunction with Allergic Living magazine.
This new asthma and allergy publication is produced by the Canadian Network for Respiratory Care in conjunction with Allergic Living magazine.

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Published by: Allergic Living magazine on Apr 04, 2011
Copyright:Attribution Non-commercial


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For years, spring meant a cold
thatnever wanted to leave me. And what acold! Cough with chest tightness andsneezing with itchy, watery eyes. On thethird year of turning up at my doctor’soffice in late March for “cold” relief, heasked: “Do you have a birch tree?”I was stunned. How had he known?Testing confirmed the “cold” was actu-
Spring Allergies:I Feel Your Pain
Take Action 
on page 32 
Dr. Robert Cowie sees a pattern
among new asthma patientswho’ve ended up in the emergency room. The specialist, who’sdirector of the Calgary COPD and Asthma Program, asks thesepatients a simple question: Why do you take your medication?He invariably gets the answer “to make me feel better,” ratherthan the correct answer: to gain control of the disease.Those patients’ quick-fix approach to asthma is widespread;the latest studies show 59 percent of Canadians with the diseasedon’t have control. But the individual situation can be vastly improved, and one of the essential tools to getting there is agood Asthma Action Plan or AAP. This is no lowly piece of paper, notes Heather Sharpe, a Calgary nurse, CertifiedRespiratory Educator and project manager of the AlbertaStrategy to Help Manage Asthma and COPD. “I like to thinkof it as a kind of living document,” she says. Especially withchildren, a plan “is always changing and evolving.”An AAP is filled out with a health-care provider: a doctor orspecialist, pharmacist or Certified Respiratory Educator. It’ssimple to do, but only 11 percent of asthmatics have a writtenAAP, revealing a chasm rather than a gap in asthma care.While there are several good action plans online, Sharpe isally an allergic reaction to birch treecatkins, those flowering spikes loadedwith pollen.Yet I adored my house with the lovely birch tree in the garden, so I continuedto suffer every spring. Allergy injectionsdidn’t seem to help. (This was my ownfault; I’d missed more sessions than Iattended.)It took me a long time to come toterms with the fact that it was my healthor that pretty tree. I suffered for twomore springs until circumstancesforced the issue.Our family moved to a different city.We made sure our new home was notnear any birch trees. What a differencenot having that tree under my nose hasmade!I’m here to tell you that allergenavoidance – whether pollen, pets ordust – is the way to go. It’s an essentialpiece of your allergy management. I stillcan’t get over how wonderful it is to feel“normal” on the lovely days of spring.
Susan O’Neil is a respiratory therapist and CRE based in Mississauga.
With kids, asthmaaction plans arealways evolving.
SPRING 2011 31
a fan of the Alberta AAP. It includes images of triggers for thepatient to circle and personal asthma management goals. Theplan works on three colour zones: green signals control, yellowindicates loss of control, and anyone in the red zone is facingan emergency.The patient can easily see what constitutes control andwhen you’re slipping into the yellow, or even the alarming red
Your AsthmaAction Plan
With Dr. Harold Kim
The Canadian Network for Respiratory Care
is a non-profit organization andregistered charity that works to improve the lives of those living with respiratory disease. We conduct exams and certify health-care professionals as CertifiedAsthma and Respiratory Educators (CAEs and CREs).Our CAEs and CREs work to help patients with their asthma, COPD, allergiesand smoking cessation efforts.For more information about CNRC or to locate a CAE or CRE, please seewww.cnrchome.net or phone: 905-880-1092.
or years, people with asthma andallergies have been telling theirdoctors that their symptomsoften affect them simultaneously. Eachspring, as the snow melts and moldand tree-pollen counts quickly climb,the nasal troubles start, including arunny nose and sneezing, as well assymptoms in the lungs, such as wheez-ing, shortness of breath and coughing.This double whammy is an annualoccurrence for many, since 80 percentof kids with asthma also have allergies,and in adults, it’s about 70 percent.Once considered separate, we nowknow that lung and nasal symptomsare connected. When you inhale anallergen into your nose, your lungs willactually become inflamed, and viceversa. And when you treat the nosewith nasal steroids, the asthma symp-toms will improve, and vice versa.Today, doctors diagnose and treat thenose and lungs together; we call it “theunited airway.Are hay fever and asthma symptomsa reality for you each spring? Here’swhat I recommend. First of all, sched-ule an allergy assessment to confirmthat you do, in fact, have allergies.Meantime, keep your windows closedto prevent pollen and mold fromentering your home. Next, asthmaticswith a predictable return of springasthma should stay on their mainte-
For more information about CNRC,contact us at: www.cnrchome.netor 905-880-1092.
nance asthma medication to preventthe airway inflammation that causeswheezing, coughing and shortness of breath. Finally, use a nasal steroid spray if your nasal allergy symptoms botheryou in the day or night.If your symptoms persist, then youshould return to your doctor for areassessment. Consider seeing aCertified Respiratory Educator orCertified Asthma Educator.zone. In the green zone, daytime symp-toms are fewer than three times a week,there are no nighttime symptoms andthe person is using their reliever orpuffer fewer than three times a week.Peak flow values are in the 85 to 100percent range. In the yellow zone,things are deteriorating and the healthprovider has clearly spelled out howand when to increase medication.Sharpe says that before having aplan, most patients rate their asthma asbetter than it is, and many considerwaking up with symptoms normal,when it’s not. The plan clarifies andhelps the patient stay on track. Dr.Cowie says an action plan should alsoprevent exacerbations. For example, if spring pollen is a trigger, prepare withthe proper changes in medication anddosages, as your health provider hasspecified. Don’t wait to make suchchanges, he advises.Everyone with asthma should havean action plan, he says. Even if you’reclassed as having mild asthma, every-one can experience flare-ups and it’simportant to be prepared.See www.canahome.org for theAlberta AAP.
True or False: Once you havea treatment plan for allergicrhinitis, you don’t need muchfollow-up with your doctor.True or False: Saline nasalrinses are helpful in treatingallergic rhinitis.True or False: Antihistaminesare more effective when startedearly in the allergy season.
Quiz answers, page 34 
Continued from page 31
Poto:rick chard
Certified Educators take yourasthma and allergy questions.
Send questions to: editor@allergicliving.com
Shirin Jetha
SPRING 2011 33
Q. How do you calm a child during an asthma attack? Mydaughter had one and started to panic, which made herbreathing worse.
Todd Gale:
Calming a frightened asthmatic child requires arehearsed plan and solid knowledge of asthma care. Asthmaattacks vary in severity and cause – talk to your doctor and a res-piratory educator about developing an action plan for both lossof asthma control and single-event asthma attacks.Some soothing actions include acting and speaking calmly with a relaxed voice; evoking your action plan; explaining what’shappening; checking in with your child often; and providingreassurance. I recommend practising your daughter’s asthmaaction plan when her asthma is controlled – you’ll attain somemastery and experience solution-focused problem solving.
Q. How can I spring clean without triggering an asthmaattack? Dust and pollen are both big triggers.
Debra Morris:
Spring cleaning can be difficult with asthma.Your asthma should be well-controlled at all times, but especial-ly prior to cleaning. Once those sleeves are rolled up, avoidcleansers with chemical fumes or fragrance. Decrease theamount of dust that’s stirred up by damp-wiping surfaces withan unscented product; you may even want to wear a mask. Sincepollen is a trigger, avoid opening windows while cleaning.Finally, it also helps to clean more regularly in order to avoidthe big seasonal cleanup in spring.
Q. My husband has been prescribed a corticosteroidinhaler for asthma. Aren’t these drugs dangerous?
Shirin Jetha:
No. Some people mistakenly think that corticos-
Todd Gale Debra Morris
teroid inhalers must be dangerous, just like the anabolic steroidsthat some athletes take illegally for building muscle. In fact, thesetwo drugs have quite different effects.The underlying cause of asthma is inflammation of the air-ways, which causes swelling and excess mucus production andleads to asthma symptoms such as shortness of breath andcough. Corticosteroids, commonly referred to as “controller”medications, help control inflammation and decrease swellingand excess mucus, thus relieving asthma symptoms.To be effective, it is important that your husband take hisinhaled corticosteroid daily, as directed. It will take two to threeweeks of continued use before he will feel a marked improve-ment of his symptoms. With time, his asthma attacks shoulddecrease, and he will need less and less of his other “reliever”medications. Since most of the dose of inhaled corticosteroidsgets delivered straight into the lungs, they have minimal sideeffects. Your husband can easily prevent the most common ones– local throat irritation, hoarseness and thrush, a common yeastinfection – by rinsing or gargling with water after each dose.
Q. Is it true that showering before bed is important forremoving pollen? It sounds like an old wives’ tale.
Todd Gale:
It is true. When you’re outdoors in spring and sum-mer, pollen grains may accumulate on your skin, hair andclothes. Washing before sleep will keep pollen out of your bedwhere it can contact your eyes, nose and mouth.Nightly showers are part of a wider approach to reduce,remove and avoid pollens. So along with the shower, think aboutchanging your clothes after being outdoors, staying indoorswhen pollen counts are highest (when the sun is high, the air isdry or a breeze is in your eye), machine-drying clothes instead of hanging them outside and washing your hands frequently.
Q. I’ve developed asthma in menopause. Any tips on how Ican still garden without affecting my breathing?
Debra Morris:
If your asthma is flaring up while you’re garden-ing, then your asthma control may not be optimal. As you’re newto asthma, you may need to visit your family doctor or specialistto see about adjusting your medication in pollen season.When gardening, you can reduce allergy exposure by avoidingwind-pollinated plants that produce great amounts of pollen,and by choosing female trees for your garden, as they don’t pol-linate. Still, keep in mind that no matter how carefully youchoose your plants and trees, you have no control over what’s inyour neighbours’ gardens – and pollen can really travel.Finally, avoid gardening on high pollution days. You can findthe Air Quality Health Index for many parts of the country atwww.ec.gc.ca (click on “Air”, then “Air Quality”, then “Air Quality Health Index”). Happy gardening!
Todd Gale is a registered respiratory therapist, CAE and sectionhead of the respiratory therapy program at Community Integrated Health Services in Kelowna, B.C. Debra Morris is a nurse and CAat Halifax Allergy & Asthma Associates in Halifax. Shirin Jetha is a pharmacist and CRE in Toronto.

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